Originally created to share news around our craniotomy adventure, the focus of this blog has now shifted to the continuing progress of recovery, general thoughts on life and staying in touch with our great community of friends.

Monday, June 1, 2009

Summer is Good

Yesterday brought us a glorious summer day and the first day in a long time when there wasn’t pressing work to be done. It was wonderful. Other than enjoying the sunshine, I spent the day appreciating, dating, labeling and organizing family photos. Shea is scanning this summer and before we add a ton of new photos to the set, it seems like a good idea to impose some order on the ones already there. It’s a big project, and long overdue.

We still feel good about the work we did on the Walker family historical photos, including putting together a family “scrapbook,” new age version, through Apple’s great iPhoto books.The resulting volume is a great thing to have and we were able to print enough for every member of the extended family--try doing that with a traditional photo album! My aspiration is to bring some parity to our worlds by repeating this for my family and our nuclear family. That and writing a chunk of the book I have under contract are my summer plans--plus, of course, work on continuing projects.

Then there’s the issue of sharing photos with those depicted in them (a gracious thing to do and one that takes even more energy), identifying people, etc. Many of my dad’s slides have been scanned, and we’re wading through that backlog at the same time. In the massive Walker project, we learned almost immediately that an unlabeled photo is a lost one. While we still have good resources, we need to identify as many people was we can in the photos before us. Yesterday, though, was all Kearney and Shea, all the time. What wonderful years we had with those magnificent little girls. They’re pretty special now, too.

Kearney and I are still noodling around with writing a piece about our hospital experiences. We’re trying to find a good way to express the disproportionate effect of the little things, which like writing appropriate thank you notes to speakers or sharing photos with those in them can take so much effort after the fundamental project is complete. In our hospital adventure, the big things (say, accurately finding and removing a massive tumor in a really sensitive spot) were done magnificently well. Obviously, those were our main priorities. We were and remain deeply grateful for them.

At the same time, the overriding experience of the hospital wasn’t about the surgery itself, it was about small things: how information was conveyed, whether staff bothered to treat us as individual beings, the small courtesies like greetings, whether we could read name tags to know with whom we were dealing, and the like. It was about whether the letter we wrote was ever read, which was impossible to tell from what felt like a blow-off acknowledgement. Yet that “little” stuff can take so much effort when you’re already tired and have used all your skills at the essence of the work. The medical staff had to make sure the physical situation was properly monitored, provide correct meds (and to a whole ward of people, not just me) and so on. Yet what we remember-- precisely because all the “big” stuff was done so professionally and well that we’re not remembering death or dismemberment, we acknowledge-- is the nurse who treated us like impediments to her “real” work and the technicians and the guy from food service who were so charming and kind.

This effort-effect paradox applies in many professional settings. That last little bit of effort on a project, not just its core, profoundly affects final judgments of the whole. No matter the care and thought that have gone into course design, they can be diminished if I don’t succeed in conveying how much the students matter as individuals in class. However good the idea for an event, it can fall short if the technology doesn’t work or there’s enough last-minute chaos that part of the program is omitted.

In the medical world it’s a technical vs. human-touch issue: it’s not enough to have good medical skills, it’s critical to have good “soft” skills in communication, empathy and listening as well. (The doctors who get sued for malpractice are by and large not those who have poor technical skills, but those whose communication skills are lacking. Likability rules: people do not usually sue people they like.) Interacting with other people takes energy and skills and we don’t always factor those into the equation. At its core, in some ways this is the difference between inner and outer directed work: it’s all about the surgeon’s skill in the operating room and about others in the conversations.

Why does that last little bit take so much energy, and play such a disproportionate role? Where do we summon up that energy to write that email closing the loop when we’re exhausted? Or make one more phone call, or have one more meeting? In organizations infested with human beings, the job is rarely done when the “me” part of the work is done, even if the other-directed part is only handing it off. As you can see, we haven’t yet hit on a clear way to express these thoughts and are still muddling our way along.

Dr. Thoughtful's office just called and has made some progress with the insurance company; another assessment tomorrow will determine whether they'll pay for more work on regaining full use of the arm/shoulder or whether what we have now is "good enough." Stay tuned. For now, it's back to the emotional labor of cleaning out years and years and years worth of paper and books from my law school office so the next chapter of my work adventure can begin. May your day’s labors be more fun than mine will be.

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Our Medical Adventure

In late August 2008, Tina was diagnosed with a large meningioma in her left parietal lobe. It was successfully removed on September 10. The very first entry from September (The Beginning) provides some background information.